Senseonics (SENS) Q4 2025 Earnings Call Transcript

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Date

Monday, March 2, 2026 at 4:30 p.m. ET

Call participants

• President and Chief Executive Officer — Timothy T. Goodnow
• Chief Financial Officer — Frederick T. Sullivan
• Chief Commercial Officer — Brian Hansen

Takeaways

• Full-year revenue -- $35.3 million, representing approximately 60% growth year over year.
• Q4 net revenue -- $14.3 million, up 72% compared to $8.3 million in the prior-year period.
• Q4 U.S. revenue -- $12.1 million; revenue outside the U.S. was $2.2 million for the quarter.
• Q4 gross profit -- $7.7 million, increasing by $3.7 million due to a full year of Eversense 365 sales and expanded consignment sales channel.
• Full-year net loss -- $69.1 million, improving from $147.7 million in 2024.
• Q4 net loss -- $20.8 million, or a $0.46 loss per share, compared to $15.5 million, or $0.40 loss per share, in the previous year.
• Gross margin -- Improved to over 50% by year-end, up from around 25% at the start of the year.
• Direct-to-consumer marketing spend -- $12 million-$15 million planned for 2026, aiming for more balanced spend across the year versus back-end loading.
• Patient growth (U.S.) -- Number of Eversense patients doubled; new patient starts increased 103% in the U.S.
• Active prescribers -- Base grew over 80% year over year.
• EON Care Group inserter network -- Ended 2025 with about 60 providers, completing nearly a quarter of U.S. insertions; goal to reach 100 providers in 2026, aiming for 30%-35% of insertions.
• Commercial transition -- Transitioned all commercial activities from Ascensia Diabetes Care to Senseonics, enabling end-to-end product responsibility and elimination of revenue sharing with Ascensia.
• Cash position -- $94.3 million in cash, restricted cash, and equivalents as of year-end, with debt and accrued interest at $35.3 million.
• 2026 revenue guidance -- $58 million-$62 million expected, equivalent to 65%-76% annual growth.
• Europe revenue contribution -- Expected to account for about 20% of 2026 revenue as the Eversense 365 launch occurs in Q2.
• Operating expenses guidance -- Anticipated $150 million-$160 million in 2026, reflecting in-house commercial integration and expanded SG&A, including a $5 million increase in R&D for the Gemini pivotal trial.
• Cash utilization outlook -- Expected between $110 million and $120 million for 2026, primarily driven by SG&A expansion.
• Debt facility expansion -- Access to up to an additional $65 million in non-dilutive capital through an expanded Hercules Capital facility, supporting increased operating expenses.
• Integration with Sequel's Twist pump -- Eversense 365 is now integrated with Sequel’s Twist automated insulin delivery system, allowing one-year continuous CGM data transfer to the pump.
• CE marking for Eversense 365 -- Received approval in January and preparing for European launch in key markets including Germany, Italy, Spain, and Sweden.
• Product pipeline -- Gemini pivotal trials to complete in 2026 with launch expected 2027; Freedom expected for 2028, featuring direct sensor-to-phone communication.
• U.S. commercial team transition -- Nearly 100% of employees successfully transitioned from Ascensia with minimal disruption.
• Seasonality -- Q4 is typically strongest due to insurance deductible cycles; company expects back-half revenue weighting for 2026 similar to 2025.
• Customer retention rates -- Historical renewal rates reported at approximately 70% from first to second sensor, increasing to 90% by the third sensor, with current retention rates characterized as "in line with our expectation."

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Risks

• Chief Financial Officer Frederick T. Sullivan stated, "Net loss was $20.8 million, or a $0.46 loss per share, in the fourth quarter of 2025," reflecting higher sales commissions and transition costs from in-house commercialization efforts.
• Frederick T. Sullivan also noted a significant planned increase in 2026 operating expenses to $150 million-$160 million, with commercial spend "consistent with Ascensia’s prior commercial spend" and increased SG&A costs due to the full in-house transition, which will elevate cash utilization.

Summary

Senseonics (NASDAQ:SENS) reported 60% full-year revenue growth, improved gross margins to over 50%, and executed a transition to fully in-house commercialization, eliminating prior revenue sharing. Eversense 365 is now integrated with Sequel's Twist insulin pump, and the company has obtained CE Mark approval to begin launching Eversense 365 across key European markets. Management guided for global net revenue of $58 million-$62 million in 2026, driven by U.S. and European expansion and a continued high investment in direct-to-consumer activities, while indicating a material step-up in annual operating expenses and cash utilization resulting from the integrated commercial model.

• Planned investment in direct-to-consumer marketing for 2026 is set at $12 million-$15 million, spread more evenly throughout the year to improve efficiency and patient acquisition cost management.
• Growth strategy includes doubling the U.S. patient base again in 2026 by focusing on patient retention, expanded provider channels, and leveraging new partnerships such as the Twist integration.
• Product pipeline advancements are expected to support future growth, with Gemini pivotal trials targeted for completion within the year and projected commercial launches for Gemini and Freedom in 2027 and 2028, respectively.
• European commercialization is transitioning from Ascensia Diabetes Care to Senseonics, with revenue contribution from Europe projected at approximately 20% for 2026 following the Q2 launch of Eversense 365.
• Historical patient retention rates indicate the largest attrition occurs between the first and second sensors, but persistence increases with each successive sensor, supporting long-term customer value assumptions.
• Management characterized the U.S. sales and organizational transition from Ascensia as seamless, with nearly full employee retention through the process and no customer disruption.

Industry glossary

• DTC (Direct-to-consumer): A marketing and sales approach targeting patients directly to drive product demand and awareness, bypassing traditional provider channels.
• EON Care Group: Senseonics' in-house network of contracted professionals providing sensor insertion services to patients.
• iCGM: Integrated continuous glucose monitoring system, a class of CGM recognized by the FDA for interoperability with automated insulin delivery systems.
• MDI (Multiple daily injections): A regimen where people with diabetes administer insulin via injections throughout the day rather than using a pump.
• SG&A: Selling, general, and administrative expenses, reflecting operational costs not directly tied to production or R&D.
• Eversense 365: Senseonics' 365-day implantable CGM system, providing up to one year of sensor life per insertion.

Full Conference Call Transcript

Jeremy Feffer: This is Jeremy Feffer from LifeSci Advisors. Before we begin today, let me remind you that the company's remarks include forward-looking statements. These statements reflect management's expectations about future events, operating plans, regulatory matters, product enhancements, company performance, and other matters and speak only as of the date hereof. These forward-looking statements involve a number of risks and uncertainties. A list of the factors that could cause actual results to be materially different from those expressed or implied by any of these forward-looking statements is detailed under Risk Factors and elsewhere in our Annual Report on Form 10-K for the year ended 12/31/2025, and our 10-Qs and our other reports filed with the SEC.

These documents are available on the Investor Relations section of our website at www.senseonics.com. We undertake no obligation to update publicly or revise these forward-looking statements for any reason, except as required by law. Joining me today from Senseonics Holdings, Inc. are Timothy T. Goodnow, President and Chief Executive Officer; Frederick T. Sullivan, Chief Financial Officer; and Brian Hansen, Chief Commercial Officer. I will now turn the call over to Timothy T. Goodnow.

Timothy T. Goodnow: Thanks, Jeremy, and I appreciate everyone joining us today. Looking back over 2025, it is hard to believe how much has changed at Senseonics Holdings, Inc. This time last year, Eversense had only been available in the United States for a few months, and we were partnered with Ascensia Diabetes Care for all commercialization and sales operations globally. We were conducting feasibility studies for our Gemini product. On the financial front, our gross margins were hovering around 25%, annual revenue was less than $23 million, and we were in the process of executing a successful cost-savings initiative to lower operating expenses.

Today, just one year later, Senseonics Holdings, Inc. is a fully integrated developer, manufacturer, and once again seller of Eversense. We have an exceptional sales and marketing team led by Brian Hansen, our new Chief Commercial Officer, and Eversense 365 is now approved in both the United States and the European Union. In 2025, we achieved full-year revenue of over $35 million, growing approximately 60% year over year. Our year-long sensor, our continued partnership with healthcare providers, and our enhanced direct-to-consumer marketing strategy have delivered tangible results with a doubling of patients on Eversense in the United States, with new patient starts growing 103%, and we have already accomplished margin improvements to greater than 50% to finish the year.

2025 was certainly a year of transformation at Senseonics Holdings, Inc. The strategic decisions we made last year established a strong foundation for growth in 2026 and beyond. The biggest decision we made in 2025 was to transition all commercial activities from Ascensia Diabetes Care back to Senseonics Holdings, Inc., removing a layer of complexity from our operations and providing us with a new level of control and agility to execute on our focused strategy. By bringing the sales, customer service, marketing, and sales operations functions in-house, we both eliminate revenue sharing with Ascensia and have the opportunity to respond quickly to meet the needs of people with diabetes.

This change also brings an impressive team of commercial professionals to Senseonics Holdings, Inc. This end-to-end responsibility for Eversense 365 unlocks operational efficiency, enhances our financial profile, and enables more integration between our corporate objectives and commercial results. Additionally, this change simplifies revenue recognition and provides critical insights into the effectiveness of our DTC efforts. PHC remains a meaningful shareholder in Senseonics Holdings, Inc. and will continue to support the European commercialization of Eversense under transition service agreements through the anticipated closing in Europe in the second quarter and establishment of our own in-country operations.

To implement this commercial evolution and drive long-term revenue growth, Brian Hansen transitioned to Senseonics Holdings, Inc. and brought with him his complete leadership and Salesforce team. Brian was formerly the head of Ascensia’s CGM division, and prior to that, the Chief Commercial Officer for Tandem, bringing a tremendous amount of experience and expertise from his accomplished career in diabetes care. In just a few minutes, I will turn the call over to Brian so that he can give you a firsthand account of what has been a smooth and successful commercial transition. He will also give his thoughts on our growth trajectory, which he will be instrumental in driving.

Excitedly, our integration with Sequel’s Twist automated insulin delivery system was another significant milestone in 2025, not just for us, but for the diabetes community at large. Patients utilizing the Twist insulin pump can now use Eversense 365 to send glucose readings seamlessly to their pump for an entire year. This means eliminating a CGM change every 10 to 15 days and providing our type 1 patients with reliable and accurate glucose monitoring, 365 days at a time. Our collaboration with Sequel combines the world’s most sophisticated glucose sensing, algorithm control, and pumping technologies and is just the first of many collaborations we hope to establish with pump partners.

Finally, in 2025, we made improvements in our financials, raised capital from institutional investors and strategic partners, executed a reverse stock split, and began trading on the NASDAQ exchange. Similar to our other transformation initiatives, we believe these accomplishments set Senseonics Holdings, Inc. up for long-term growth and disciplined financial execution.

Moving on to the leading indicators for 2026, I will start with a quick reminder that our business is seasonal. The fourth quarter is typically our strongest quarter due to insurance deductibles being met. Further, a higher number of existing customers are available for reorders of our Eversense in the quarter, because the U.S. commercial launch of Eversense 365 took place in 2024, so early adopters translate into annual reorders beginning in this fourth quarter. Through this, we saw meaningful quarter-over-quarter growth for the entirety of 2025, including growth in leads, conversions, new patient starts, and prescribers of our sensor for the first time.

We expect this momentum to continue in 2026, buoyed by our growth initiatives and investments, the Twist integration, and expansion of Eversense into new markets.

In January, we received CE marking for Eversense 365, and we expect to launch one global product in Germany, Italy, Spain, and Sweden in the coming months with our own dedicated European sales force. We recognize that patients and providers in Europe have been waiting for us to deliver on our promise of “one year, one CGM” in their markets, and we now have the approval. We anticipate a similar uptake in interest in new patients on Eversense as we had in the United States.

On the product pipeline front, we continue to advance development of both the Gemini and Freedom products. We expect to complete the Gemini pivotal trials before the end of the year, with the launch expected to follow in 2027. Gemini improves on the capabilities of Eversense 365 with an integrated one-year battery and flash glucose monitoring capabilities without a transmitter. Freedom is close behind with launch planned for 2028. The Freedom system further improves on Gemini, incorporating direct wireless communication between the sensor and the patient’s phone.

I am confident that our decisions and execution in 2025 will form the foundation of our 2026 growth. We have the right team, the right financial structure, and the world’s first and only year-long CGM to improve and simplify the lives of millions of patients worldwide. I will now turn the call over to Brian Hansen.

Brian Hansen: Thanks, Tim, and hello to everybody on today’s call. I would like to begin by expressing my excitement to be part of Senseonics Holdings, Inc. and my gratitude to the U.S. commercial team that has transitioned to Senseonics Holdings, Inc. from Ascensia. Here in the United States, the move was fairly straightforward. We were very happy to see nearly 100% of the employees transition with us. We were also able to recognize a few synergies in the move, as well as shifting several roles around to better align our teams for success in the new year.

The same effort is underway in Europe where I expect the same result, and we have the launch of Eversense 365 right around the corner. More on that later.

As Tim mentioned, the strategic decisions taken in 2025 set us up for continued success in 2026 and beyond. Our direct-to-consumer spend was a big growth driver for us in 2025, and we will continue to invest heavily in that channel this year. It was clear with our revamped DTC campaign and enhanced spend that we could drive significant lead volume, and leads drive awareness, patient interest, prescriptions, and ultimately new insertions, translating into top-line revenue. There were multiple learnings from our work in 2025. Last year’s back-end-loaded DTC spend showed there is a sweet spot of investment for us.

While we plan to spend a similar amount this year, roughly $12 million to $15 million, we will spend it a little more evenly over the entire year, building into the third and fourth quarters. This should allow us to be more efficient with our resources, targeting higher-quality opportunities, a higher close rate, and a lower cost per lead.

Another important initiative for 2026 is patient retention. While we are early in the renewals from our first patients on the Eversense 365 sensor, we are happy to report that patient retention is in line with our expectation. This is and will continue to become a more meaningful part of our business going forward. Programs put in place in 2025, as well as allocating resources to refine and enhance the patient journey with our product and our company, have positioned us nicely for the upcoming year.

I would also like to express my gratitude to the legacy employees at Senseonics Holdings, Inc. that have built such an amazing product. Not only does it last a full year as expected, its performance is unsurpassed. We have also been working diligently to support the Sequel Twist–Eversense 365 rollout and expect to see an increase in the type 1 patients we serve as a result. As Tim mentioned, this collaboration enables us to combine two of the world’s leading diabetes technologies to simplify life for patients requiring insulin. Anecdotally, I can tell you that from the team being at the Sequel annual sales meeting held earlier this month, we are both aligned and excited.

Sequel has a large commercial presence in the United States, and I can confidently say that both teams have fully bought into this partnership. Now with Eversense 365 compatibility, Sequel is able to offer customers choice in selecting the continuous glucose monitor that works best for them.

As a company, we more than doubled the number of Eversense users in the United States from 2024 to 2025, and for this year, our goal is to continue that momentum and double our patient base once again. We believe that we can accomplish this through successful renewal of our existing customers, driving new patient starts in the U.S. and abroad, and having pump integration, which patients have requested for years. Acknowledging we are only a few weeks into the general availability of the combined offering, the results have exceeded my expectations.

We have detailed the success of our DTC campaign from last year, so let us turn to our healthcare provider channel that continues to grow as well. The number of providers actively prescribing Eversense grew more than 80% year over year, reflecting broadening awareness and confidence in the 365-day system. Access to the diabetes centers continues to grow and we look forward to working closely with the Sequel commercial team to expand our combined reach. We also saw continued expansion of the EON Care Group, our in-house inserter network. We finished the year with approximately 60 providers performing nearly a quarter of all U.S. Eversense insertions.

We will continue to add to this team in 2026, planning to end the year with approximately 100 providers, driving an even greater percentage of U.S. procedures.

Turning to the European launch and transition for a moment, we are in the final stage of completing our European arrangements with Ascensia, and both companies’ teams are collaborating well to smoothly transition the European CGM business. Our team is working to establish the full organization we need in Europe, and we will utilize transition agreements with Ascensia in countries where we are currently building out our capabilities. Overall, we made great progress with the transition since the announcement in early September. Coming off our national sales meeting to unveil the new Senseonics Holdings, Inc., the team is energized and off to a good start to the year.

This is a testament to our employees’ hard work in getting here, their dedication, their belief in the product, as well as the potential future growth ahead of us. I will now turn the call over to Frederick T. Sullivan to walk through the numbers.

Frederick T. Sullivan: Thanks, Brian, and thanks to everyone joining us this afternoon. Starting with the quarterly results, in the fourth quarter of 2025, net revenue grew 72% to $14.3 million compared to $8.3 million in the prior-year period on the continued strength of top-line Eversense 365 revenue. U.S. revenue for the fourth quarter was $12.1 million, and revenue outside the U.S. was $2.2 million. Importantly, in 2025, we continued to recognize revenue through the collaboration agreement with Ascensia. We anticipate recognizing 100% of revenues going forward. We expect a similar channel mix going through our two primary sales channels in the U.S.: direct shipments to DME distributors and through bundled payment of the procedure and product, primarily through our consignment program.

Outside the U.S., we will sell both through tender agreements and to distributors depending on the region.

In Q4 2025, gross profit was $7.7 million, an increase of $3.7 million from the prior-year period. This increase in gross profit was primarily driven by a full year of sales of Eversense 365 with more of our business going through our consignment sales channel where we recognize 100% of the revenue and recorded a sales commission expense to Ascensia based on the current year’s revenue-sharing percentage. Research and development expenses in Q4 2025 were $8.8 million, a decrease of $0.6 million compared to the prior-year period. The decrease was primarily due to the completion of 365 system clinical trials and development efforts as well as a reduction in headcount.

Fourth quarter 2025 selling, general, and administrative expenses were $19.8 million, an increase of $10.9 million compared to $8.9 million in the prior-year period, primarily driven by higher selling and marketing personnel costs, promotional expenses mainly due to the DTC investments, sales commission expenses as our consignment program expanded, and other general and administrative costs, including transition costs incurred to support the commercial transition from Ascensia.

Net loss was $20.8 million, or a $0.46 loss per share, in the fourth quarter of 2025 compared to a net loss of $15.5 million, or a $0.40 loss per share, in the fourth quarter of 2024. Net loss increased by $5.3 million primarily due to increased sales commissions and other costs related to taking over the commercialization and distribution of Eversense. For the full year, total revenue was $35.3 million compared to $22.5 million in 2024. U.S. revenue was $27.9 million in 2025, compared to $15.3 million in the prior year, and the revenue outside the U.S. was $7.4 million in 2025 compared to $7.2 million in 2024.

Net loss for 2025 was $69.1 million compared to $147.7 million in 2024. The decrease in net loss was primarily driven by improved margins in our business from Eversense 365. Selling, general, and administrative expenses for 2025 increased by $18.3 million year over year to $52.5 million. The increase was primarily driven by our direct-to-consumer campaign investments, sales commission expenses as we increased consignment sales, and costs related to the Ascensia transition. Research and development expenses for 2025 decreased by $9.5 million from 2024 to $31.6 million. The decrease was primarily due to the completion of the Eversense 365 system clinical trials and development efforts as well as a reduction in headcount.

As of December 31, 2025, cash, restricted cash, and cash equivalents totaled $94.3 million, and debt and accrued interest was $35.3 million. We expect full-year 2026 global net revenue to be approximately $58 million to $62 million, representing year-over-year growth of 65% to 76% as the company completes the transition of Eversense commercialization from Ascensia and brings the entire sales and marketing infrastructure in-house. Due to the seasonality of our business, deductibles resetting at the beginning of the year, and higher utilization of patient assistance programs, we expect to receive the majority of our revenue in the second half of 2026 consistent with what we saw in 2025.

Taking into consideration our margin performance to date, along with the planned launch of Eversense 365 in Europe, which will allow us to be on a single product globally, we expect full-year 2026 gross profit margin to be greater than 50%, beginning slightly lower and increasing sequentially.

We are excited to simplify our business model with the integration of the commercial organization and will recognize improvements in our top line and the expansion of our gross profit margins. Due to the integration of the commercial organization and supporting transition service agreements from Ascensia, we expect operating expenses to increase by about $70 million, consistent with Ascensia’s prior commercial spend. In 2026, we expect total operating expenses to be between $150 million and $160 million, with increases primarily in SG&A and a smaller increase in R&D for the Gemini pivotal trial.

We expect cash utilization in 2026 to be between $110 million and $120 million, largely as a result of increasing SG&A due to bringing the sales and marketing teams in-house. Last year, we expanded our debt facility with Hercules Capital to $100 million, providing access for up to an additional $65 million of non-dilutive capital to help fund our increased operating expenses for the integrated business. With that, I will turn it back to Tim.

Timothy T. Goodnow: Thank you, Rick. These are exciting times for Eversense with the accelerating growth of our revolutionary 365-day product. We have delivered significant new patient additions and top-line growth across 2025, driven by expanding awareness and adoption of Eversense in the U.S. DTC investments continue to pay dividends as more people become aware of the compelling benefits of our product, and we now have access to a whole new population of patients following the launch of our first AID combination. Our margins are improving, and the sales force continues to gain traction with a productive and energized sales force post transition.

We are already seeing encouraging retention with many early adopters now on their second year-long sensor, restarting the clock on 365 days of the best-in-class continuous glucose monitoring system. In our exciting pipeline, the disruptive Gemini and Freedom programs are advancing, and we look forward to updating the market on continued progress in due course. Overall, this was a record-breaking year for Senseonics Holdings, Inc., but it is only just the beginning. Having demonstrated strong commercial progress, we have more confidence than ever in the clinical and commercial potential of Eversense. We also have control of our destiny following the transition, with the right strategy in place and the right people leading the charge.

Thank you all for joining us today and for your continued support. We look forward to building on the momentum from the first year of Eversense 365 with another year of growth in 2026. With that, I will now turn the call over to the operator. We will now open for questions.

Operator: Thank you. At this time, if you would like to withdraw yourself from the queue, you may press 2. Once again, to ask a question, please press 1. We will take our first question from Anthony Charles Petrone with Mizuho Group. Your line is open.

Anthony Charles Petrone: Thanks, and good afternoon, and congrats on a strong 2025 execution year. Maybe, Tim, Rick, Brian, I will start with some of the trends you are seeing here early in the year. You are coming off 2025, 103% new patient starts for the year, hit a new high in the fourth quarter, and I know, Rick, obviously, there is a little bit of seasonality on policy resets here as you start the year. But anything you can provide just in terms of U.S. new starts at the beginning of the year here? And then I will have a couple of follow-ups.

Frederick T. Sullivan: Sure, Anthony. Thanks for the question and timing. We continue to do very nicely on new patient starts. The 365 product continues to perform just as we expect. Excitedly, we are now into the more routine cycle of getting the reinsertions. So new patient growth continues as we have expected it to, as we planned it to. January typically is our softest month with the patient resets, but we planned for that. Very encouragingly, we have seen a surprising amount of interest with the Sequel product and new patient starts associated with that, so that is very encouraging to see.

And we continue to make progress, as you know, with the key markets for the 365 in Europe, so we are looking for that region to really take off as well here later in 2026.

Anthony Charles Petrone: The follow-up is on that top-line guide, $58 million to $62 million. You have the U.S. clearance here earlier in this year as well as the Twist product launch on February 19. To what extent in that range do you have some contribution for Europe and Twist? And maybe just a recap on Twist specifically: how are the economics split between Sequel and Senseonics Holdings, Inc.? Thanks again. Congrats.

Brian Hansen: Sure. I will let Rick speak to Europe. From an economic perspective, it is two companies that work together from a marketing and awareness perspective, but the economics are unique to each company. So we sell a sensor, we recognize the associated economics. They sell a pump, and then through the integration that the iCGM enables, the patient enjoys that combination. So there is really no difference economically on a brand-new patient start that is on MDI versus somebody that is on a Sequel pump.

Frederick T. Sullivan: And then for Europe, the past couple of years, we have seen fairly consistent revenue in Europe, and so that, along with the elimination of that revenue share to Ascensia, we do expect Europe to be about 20% of our revenue in 2026, with the growth with the 365-day launch in Q2.

Anthony Charles Petrone: Helpful. Thanks.

Operator: We will move next to Joshua Thomas Jennings with TD Cowen. Your line is open.

Joshua Thomas Jennings: Hi, good afternoon. Thanks for taking the question, and it is great to see that you are on track to double new patient starts and the patient base again this year. I just wanted to check in on the takeover of the commercial organization in the United States from Ascensia. It seems like it has been seamless. All the sales reps converted under the Senseonics Holdings, Inc. roof. But is it as seamless as it sounds, and have there been any friction points?

Brian Hansen: Yes, Josh, thanks for that. It is a good question. It really was as simple in the U.S. as it sounds. It was as straightforward as we expected. They changed business cards. They got a new computer. They had to do a few things. We even pulled their cars over with them. Quite frankly, it went that simply. We have a full boat, and they all stayed, and so we are very fortunate. Outside the U.S., we have a little bit more work to do as we go through the transition here in the first half of the year, and we are hiring new folks to replace our BGM reps that were supporting both products outside the U.S.

That has a few moving parts to it differently than the U.S., but so far, the U.S.—we had our kickoff meeting in late January in D.C., and everybody was there and excited and focused. As I said in my comments, that one has gone very well, knock on wood.

Joshua Thomas Jennings: Excellent. And do you mind just reviewing where maybe some deficiencies were with Ascensia at the helm of the commercial effort? Was it investment levels in DTC? Was it aggressiveness in pursuing new prescribers? And how are you filling any voids that were in play prior to taking over the commercial effort in the U.S.?

Timothy T. Goodnow: The strategic execution around the commercial activities really did hand over one-for-one. Even in Europe, where we had some opportunities, it is the operational part of the organization. For example, there were some duplication that happened, some strategy elements that happened. So in those cases, we did do some rationalization, but obviously, since there was just a little bit of upstream marketing around product development that existed in the prior Ascensia organization, that has now been folded into the new Senseonics Holdings, Inc. commercial team.

Brian and Rick and Ken, our GC, really did an exemplary job leading this transition to be able to get every sales rep, every inside sales rep, to be part of Ascensia at 5 PM on Friday and show up at 8 AM on Monday as a Senseonics Holdings, Inc. employee, which was really, really impressive. And there was absolutely zero—knock on wood—customer impact through that transition. It has just been managed and executed with great ability.

Joshua Thomas Jennings: That is impressive. And with the active prescriber base growing 80% last year, and with Senseonics Holdings, Inc. now in control of the commercial offering and the sales team, how do you expect that prescriber base to grow, one? And then two, you are on track—your guidance when Ascensia was in control of the commercial effort was to double your patient base in 2025 and 2026 on the heels of the Eversense 365 launch. With complete control now, could you do better than that? Could you see an acceleration in the prescriber base and new patient starts from this doubling, which is an impressive number? Do not get me wrong.

Brian Hansen: Easy, Josh. Thanks for the questions.

Timothy T. Goodnow: Certainly sounds like Brian is signing up for more than that. In all seriousness, it is a significant push. In 2025, we accelerated the DTC under the expectation—and I think we validated that perspective—that this is really about awareness. As we spent in DTC, we made more and more patients aware, who then in turn worked with their providers and made more and more providers aware of the opportunity with Eversense and the excitement around 365. For us to continue to sustain that level of growth, obviously, as Brian said, we are going to spend a significant amount in DTC, about the same that we spent last year.

We just did back-end load it in the back half of the year. So the ramp is commensurate with that investment. We expect that ramp to slow down a little bit with the normalization of that spend over the year, but still supporting that doubling of growth, or approximately 70% revenue growth across the whole company.

Joshua Thomas Jennings: Understood. That makes sense. Thanks for the answers.

Operator: We will take our next question from Matthew Miksic with Barclays. Your line is open.

Matthew Miksic: Great. Thanks so much for taking the questions and congrats on the great progress and results. Maybe some follow-ups. Lastly, on the investment in DTC, it proved to be pretty successful last year. Within the spend this year, how are you thinking about it? Are you front-end loading it, back-end loading it? Has it just become a reliable and important budget item? Just any color you can give us on size or the direction of DTC spend would be great. And I have a couple of quick follow-ups.

Brian Hansen: Yes, so Brian here. We will spread it out a little bit more this year. It was again, as Tim said, more in that last six months, and we really put quite a bit in that September, October, November timeframe. That is when you want to put a bunch in as the fourth quarter is so strong, but we also really stressed our team by doing that. Now, to level load it a little bit more—spending not quite half in the first half of the year and then saving a little bit to push into that really important third and fourth quarters—is how we are looking at it.

We also learned a lot last year about what works and what does not work, what segments we were getting better returns versus others. I think we are going to do a much better job this year taking our same spend but maximizing it, and our team is right-sized for that as well right now. So we are expecting to spend the same but get better results as we spread it out across the year. Dollars—$12 million to $15 million—is what we said in our prepared remarks.

Matthew Miksic: Okay. That is helpful. And then, the challenges or the friction around getting more implanters up and running, getting more education out there—the DTC is part of that—what do you see as the primary constraints right now in terms of growth, in terms of your ability to address new patient interest and new clinician interest? What are the things you are trying to address to feed things and make the most of the opportunity you have? And then I have just one last question, if that is okay.

Timothy T. Goodnow: Sure. Number one, Matt, it continues to be, as I said, about awareness, and that is where the DTC really helped. That drove it from the consumer level, and then we certainly augment that with a strong internal team that takes the inbound interest, does the facilitation, the adjudication, the communication of the economics, and works with the outside sales team, which also plays a very big role in the awareness on the clinical and professional side. We are going to continue to do that. We have 45 regions right now that are focused in the primary areas, and they are working hard to not only expand their reach but also to go deeper within the clinic.

We think that is an opportunity as well—to make sure that instead of one or two doctors in a clinic being heavy prescribers, we are going to turn that into three, four, five prescribers. So number one is certainly about awareness. Number two, from insertion, you are absolutely right. We are going to continue to focus on it. That said, recall that our EON program is a major initiative for us. We ended the year with about 60 nurse providers that were contracted with us to do the insertions, and we are absolutely on target here, as we are now two months into it, to end the year at 100 nurses.

We anticipate they will be doing 30% to 35% of all of our insertions in that time period. So a lot of organic growth through that support initiative as well.

Brian Hansen: We saw a lot of changes in reimbursement last year going from 180 to 365. Certainly, the first three to four months of the year, we had some things to work through. We revamped that team. We have seen quite a few good results from that and are really getting a clearer picture of reimbursement, making it easier for the physician and the patient to know exactly how this is all going to work. As Tim said, the insertion and reimbursement piece—we have come a long way over the last 12 months, and so we really believe we will benefit from that in 2026. We are becoming easier to work with, and the volume has certainly helped with that.

Timothy T. Goodnow: And, Matt, you will recall there was a little bit of a hurdle in early 2025 with the physician fee schedule. They first came out with G-codes and then transitioned to the standard CPT codes. We do not have that this year. They published the results for 2026 that started right away. So we have been into the economics and implementation of those right from the very beginning of this year.

Matthew Miksic: That is great. And then just lastly, on the type of new folks signing up—new users, experienced users, where they are coming from, the reasons, and there are lots of reasons why they might choose Eversense—what are some of the reasons, and maybe how that changes, if at all, and how it has changed? Thanks much.

Timothy T. Goodnow: Matt, I will let Brian speak to the change, which we are absolutely seeing now with an AID partner. But from an investment perspective, much of our DTC—and quite frankly, the fast-turn nature of the buy-and-build—really makes this an attractive product for people that are on Medicare. We have transitioned to probably 70% type 2 patients in 2025, or at least coming out of 2025. I expect that proportion will actually change back more towards type 1 now with the pump partner. We continue to see the majority of our patients are switchers that are either coming from one of the two transcutaneous sensors, with about 15% to 20% brand new to the space.

On the new pump rollout, it has been very encouraging.

Brian Hansen: That is great. Spot on.

Operator: We will take our next question from Marie Thibault with BTIG. Your line is open. Hi, good evening. Thanks for taking the questions and nice job on this quarter for sure. I wanted to ask a follow-up here on the EON Care inserter network. You mentioned moving from 60 to 100 this year. What is the gating factor on expanding that more quickly? I know they are doing about a quarter of volumes. It seems like it could move to a third or better of volume. So what challenges, if any, are there in expanding that network and moving more quickly on that opportunity?

Brian Hansen: Marie, there really is not. It is really about volume and having enough work for them, and there is really no downside going to 125 or 150 if the volume justifies it. We can keep them busy, and we can identify folks in the areas where we need them. That 100 mark seems like a sweet spot. Getting an increase in the percentage of insertions that they do is good for everybody—our economics as well, the quality of the work—and it frees up the physicians in the prescriber-only areas where they really do not want to do it. That is kind of a goal, but it could exceed that. There is nothing that stops us from doing more.

We just need to have the volume to keep them busy and justify putting those in places and getting accredited, certified, and trained. It is a good question. There really is no barrier.

Marie Thibault: Okay. Good to hear. And as a follow-up on the operating spend level that you discussed, I think $150 million to $160 million this year, I understand that the bulk of that is picking up where Ascensia left off in terms of the spend. But maybe we can get longer term and understand: is this a multiyear investment? Should we expect continued step-ups in the out years? Certainly just want to understand it now under the Senseonics Holdings, Inc. roof. Thank you for taking the questions.

Frederick T. Sullivan: From the commercial spend perspective, it will certainly continue to grow as our revenue grows, but not at the magnitude that it is in 2026. It will be more efficient. As we launch new products, we will expand the number of territories, increase the number of providers from the EON Care, etc. But it will decrease as a percentage of revenue going forward. This year, we do have a Gemini clinical trial, which is about a $5 million increase in our R&D line. We will see a similar amount next year for the Freedom trial, but then R&D should go down for further out years.

Marie Thibault: Alright. Helpful detail. Thank you, Rick. Yep.

Operator: We will move next to Jonathan Block with Stifel. Your line is open.

Jonathan Block: Great. Thanks, guys. Good afternoon. Tim or Brian, anything around the timing of additional pump partnerships coming on board? Do you expect that in 2026? And then, Rick, does the guidance arguably take into account any thoughts on additional pump partnerships this year? Thanks.

Timothy T. Goodnow: We do continue to work with additional pump opportunities. We are not yet announcing any of those or going public with them, but we do have quite a bit of interest. Obviously, getting the first one out creates a little bit of a dynamic of there being only one pump company right now that has access to the Eversense, and they have seen an encouraging conversion as a result of that. We certainly expect that is going to work in our favor. But we have not, as of yet, modeled additional pump companies in. We would look for that to be upside, but still not announcing timing on the next one yet.

Jonathan Block: Okay. Thanks for that. And then just to get a little bit more granular on the revenue—Rick, you provided some details on the cadence. It was more, I believe, what you alluded to: 2H 2026 versus 1H. But any more details you can give, just even 1Q due to some of the moving parts with Ascensia? When I look at straight around $10 million and those moving parts, and here we are in early March, is that a good figure to set ourselves and then think about the other commentary you provided—2H versus 1H? Thank you.

Frederick T. Sullivan: From a revenue perspective, we know that we have the seasonality in Q1 with the deductibles resetting and a higher utilization of our patient assistance programs, which impacts the ASP through that channel. Then also, the second half of the year is typically where we have now some large renewals from the past couple of years with the 365 launch. The revenue is certainly back-half loaded. I do expect it to be similar to 2025—thinking about 40% in the first half, 60% in the second half, approximately. We will see a step down in Q1 because of that seasonality from where we were in Q4.

Jonathan Block: Okay. Great. I will follow up with you guys offline. Appreciate it.

Operator: We will move next to Benjamin Charles Haynor with Lake Street Capital Markets. Your line is open.

Benjamin Charles Haynor: First off for me, on the DTC marketing, what sort of lessons are you learning there? For instance, areas where you have more users, do you see a greater impact from advertising? Does greater awareness in a given area translate to cheaper user acquisition? How should we think about some of the dynamics of the DTC marketing?

Brian Hansen: We could talk about that for hours. First and foremost, we tend to really focus where we have qualified inserters. We have played with that geography boundary. We can geofence our spend. It is very interesting when you start moving at 75, 100, 125 miles how you start to reduce the effectiveness of it when you get too far away from an inserter. To Marie’s question earlier, getting more insertion areas and coverage really helps us match efforts going forward. Then you get into the different channels, the different markets that you try to pour a little bit more into, and typically success breeds success there. We watch that very closely.

When we see areas where we get a better return—lower cost per workable lead, all the things that we follow very well—we pour more in until we see it diminish at that point. Then we certainly test a whole bunch of different ads and methods. The team is constantly changing those almost on a week or two-week basis in different markets at times as well. The sophistication is very interesting. What we found last year is we did fairly well, especially with the robust Medicare reimbursement we had. We really started to lean into some of those areas, and again, where we had proper coverage for insertion.

I could go on and on with the different levers we pull, but you really do start to lean into those areas where you are doing very well and continue to invest more and more until you see it start to slow down a little bit. That is some of the learnings we have from last year and will continue this year, but I think we have a more focused effort as we go into 2026.

Benjamin Charles Haynor: Okay. That is helpful color. Are you seeing any changes to the behavior of new prescribers with the 365-day version?

Timothy T. Goodnow: No, I would not say there has been a change in behavior. Certainly, at this level, the recognition and now the feedback—it is much more common to see feedback from users now that have gone on to their second sensor. The retention rates are encouraging. People love the product. When they use it for as long as a year, it becomes part of their life. From that perspective, a convert is very attractive to us. From a new patient perspective, I do not think you see any real behavior differences from what we have seen before, nor from the prescriber side.

Benjamin Charles Haynor: Got it. And then on that retention comment, can you remind us where the expectations are for retention and whether they are being exceeded?

Timothy T. Goodnow: We have not updated those as yet, as we are still pretty early into the one-year renewal cycle. Our history had been—from first to second sensor—it was in the 70s. Second to third sensor was in the 80%. Then by the time people were on the third sensor, it was 90% retention, sometimes even higher, as is evidenced in our European market. I would anticipate that the largest drop-off is from first to second, but still some pretty attractive rates.

Benjamin Charles Haynor: Got it. Thank you for the color, gentlemen, and congrats on the progress.

Brian Hansen: Thank you. Thanks.

Operator: We will move next to Sean Lee with H.C. Wainwright. Your line is open.

Sean Lee: Hey, good afternoon, guys, and thanks for taking our questions. I just have two of them. First, for the European market, what is the expected timeline for the rollout there? Are you seeing any hurdles from the transition, especially as I know some of these are affected by local purchase agreements?

Timothy T. Goodnow: The timing is consistent, as we have guided since the beginning of the year, that being we expect the transition to occur in the second quarter. That is gated by the transitions that we are going through right now. Many of these markets are tender markets, so they are contracted with Ascensia, and we are transitioning those to Senseonics Holdings, Inc. We are in that process right now. We did receive CE Mark approval, so we have the authorization to go. We would anticipate that by mid-second quarter we will be rolling out the product into those markets. Some of the tenders will go through the summer, even into early fall, depending on the contracts that we have.

May through September/October time period will be the transition.

Sean Lee: Great. Thank you for the clarity on that. My second question is on the Gemini study and how the potential approval would go for that. I was just wondering, is the FDA requiring a second AMR for the flash mode for the Gemini because it has different functionalities versus the Eversense 365 sensor? How does the inclusion of the dual modality impact the complexity of the trial?

Timothy T. Goodnow: The FDA will expect that in the flash mode, or in the near-field mode with the transmitter, it will give you the same result. The expectation is it is the same chemistry, the same sensor. Our expectation—and their expectation—should be that it is iCGM compliant. As you recall, our MARD is around 8% that supports that, and we do not have any reason to expect that would change. Technologically, there should be no reason why you get a different result in flash or with near-field.

Sean Lee: Got it. Fantastic. That is all I have. Thanks for taking our questions.

Timothy T. Goodnow: Great. Thanks, Sean. Thank you.

Operator: This does conclude our question-and-answer session and today’s conference. You may now disconnect your lines. Thank you for your time and have a great day.

Timothy T. Goodnow: Goodbye.

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